This application proposes Jean C. Beckham, Ph.D., for a K24 Mid-Career Investigator Award in Patient Oriented Research. Dr. Beckham is currently one of seven tenured women in the faculty of 413 at Duke University Medical Center Department of Psychiatry, and an accomplished PTSD and health researcher. Dr. Beckham demonstrates (a) her strong clinical research interest in co-morbid cigarette smoking and PTSD, (b) an outstanding research and clinical environment within Duke University Medical Center in which to conduct patient oriented research; (c) her unique position within the institution to nurture the careers of junior investigators, and (d) the need for protected research time to continue and expand these efforts. The K24 Mid-Career Investigator Award would permit Dr. Beckham to build on her previous program of patient-oriented research and training for clinical investigators, with a focus on smoking cessation and relapse prevention in PTSD and trauma-exposed smokers. Cigarette smoking is the number one avoidable cause of death and disability. Psychiatric patients consume 44% of all cigarettes. It is estimated that PTSD affects 2.6 million Americans, and that t .6 million of these patients are smokers. The chief aim of this proposal is to use time liberated by the Mid-Career Investigator Award in Patient-Oriented Research to increase the candidate's knowledge of several areas relevant to her future research and to develop, evaluate and disseminate new information on the treatment of smoking and PTSD. To this end, the career development plan increases the candidate's experience, knowledge, and skills in the following areas: 1) evidence-based smoking interventions for psychiatric populations; 2) statistics; and 3) intervention study design and methodology. The career development plan also proposes to: 1) increase awareness of the health effects of PTSD by educating professionals and the public, and 2) expand the candidate's mentoring of beginning investigators with the goal of attracting them to a career in patient-oriented research. This application's research plan focuses on two ongoing R-01 studies of PTSD, other ongoing research, and two proposed projects: 1) a CBT treatment component development for smoking cessation in PTSD (R-21 application) and an efficacy/effectiveness trial (R-01 application) to investigate optimal smoking cessation interventions for PTSD patients. In summary, this award would provide critical support for the candidate's career development, mentoring, and ongoing and new patient-oriented research on an understudied, relatively common, and severe co-morbid problem.